Vitamin D Deficiency Rickets in Riyadh

Abstract

Despite the fact that much of Saudi Arabia is sunny throughout most of the year, vitamin D deficiency rickets is not rare. Different factors are responsible for this phenomenon, especially nutritional, social, and maternal vitamin D deficiency. We identified 500 cases of rickets out of a total of 27,236 hospital admissions, and followed at Suleimania Children's Hospital in Riyadh over three years (1986 to 1988). Eighty-one percent of the patients were Saudi (mean age, 8.2 months), which is significantly lower than that usually observed. Most of the patients had nonspecific findings at onset, indirectly related to the vitamin D deficiency, particularly recurrent chest infections (66%) and hypocalcemic convulsions (17.2%). The young age at onset, which was 39.2% in patients younger than six months at onset and 14.2% in those younger than three months, is unusual compared with ages cited in the literature, and this most probably relates to maternal vitamin D deficiency. Subclinical forms of rickets, detected by the screening, also seem to be common. We conclude that rickets is a major health problem in Saudi Arabia and more attention needs to be paid to its detection, treatment, and prevention.A Abanamy, H Salman, M cheriyan, M Shuja, S Siddrani, Vitamin D Deficiency Rickets in Riyadh. 1991; 11(1): 35-39 Vitamin D deficiency rickets is due to dietary factors and poor sunlight exposure. The incidence of vitamin D rickets is therefore usually low in sunny countries, but in Riyadh it is not rare.We evaluated the factors associated with the development of rickets in our community, and discuss the preventive measures that should be adopted. Patients and MethodsRickets was diagnosed in 500 patients (out of a total of 27,236 admissions) and patients were followed at Suleimania Children's Hospital in Riyadh over a period of three years (1986 to 1988).Diagnosis was based on clinical (widened wrists and rosary rickets), radiological (rosary rickets, widening, cupping, fraying of distal ends of the ulna and radius), and biological (high alkaline phosphatase activity) findings. Furthermore, 1213 breastfed Saudi children below two years of age, seen in the outpatient clinic for nonspecific

Vitamin D Deficiency in the Middle East and its Health Consequences for Children and Adults

“…Furthermore, rickets accounts for a substantial number of pediatric hospital admissions in the region. A report of 500 cases of rickets admitted at the Suleimania hospital in Riyadh between 1986 and 1988, estimated that the diagnosis accounted for 1.8% of all hospital admissions for that period [15], it was estimated at 1% in a hospital based study conducted in Saudi Arabia [16], and at 6.5% in a similar study of newborns from Kuwait [17]. Rickets accounted for 10.6% of all admissions for infants presenting with an acute illness to a hospital in Jordan [18].…”

Differences in vitamin D status and calcium metabolism in Saudi Arabian boys and girls aged 6 to 18 years: effects of age, gender, extent of veiling and physical activity with concomitant implications for bone health

“…These countries have experienced rapid economic and social changes during the past two decades, resulting in a marked improvement in lifestyle and health status (6)(7)(8)(9)(10)(11) . However, these rapid changes have led to the development of a paradoxical situation regarding nutrition, in that both a lack of and an excess of nutrition coexist.…”

“…However, these rapid changes have led to the development of a paradoxical situation regarding nutrition, in that both a lack of and an excess of nutrition coexist. Undernutrition has manifested as growth retardation/bone deformity among pre-school children and Fe-deficiency anaemia, while overnutrition has manifested as obesity, dental caries and non-communicable disease (5,(7)(8)(9)(10)(11) .…”

Fractures: Abuse or Rickets?

“…In these cases, rickets is likely due to severe hypocalcemia in a newborn of a mother with severe osteomalacia (19). Fractures are rare and, when present, occur in the background of the classic radiographic rachitic changes of fraying and cupping of the metaphysis and with severe biochemical alterations (20)(21)(22)(23). Ayoub and Hyman cite concerns regarding confusion between child abuse and rickets in young infants, but the only published literature given in support of this idea is a commentary that used illustrative medical-legal cases in which the authors reviewed the materials for the defense (24).…”